Managing labour pain – what are your options?

Labour can be painful, but there are many options available that can help you manage the pain. It’s good to learn about what these are before you go into labour.

You’re having a baby! You may be feeling excited, a little nervous and likely wondering how much labour will hurt and how you are going to cope with the pain. Fortunately, there are many different methods to help ease the pain of labour, including a variety of medicines and natural pain relief options that have been tried and tested over the years.

Pain is a normal part of labour and is experienced differently by every woman. It is often described as a unique feeling, and of course it is associated with a wonderful and meaningful life event – the birth of a new baby. You can help prepare yourself for labour pain by gaining a better understanding of your options for pain relief, how they work, and the effect they will have on you and your baby.

Just like the experience of labour itself, your pain management choices are very personal and should be based on your physical and emotional needs. You may already have a very clear idea of the pain relief you want or don’t want, but it can be helpful to keep an open mind – depending on how your labour progresses, you may choose to change your pain management plan or use a combination of methods. Whatever happens on the day, your midwife and/or doctor will be on-hand to support you with what is best for you and your baby at the time.

Here are some of the most common options for managing labour pain:

Natural relief for labour pain

1. Active birth

Thanks to what we often see on TV and in movies, many women still expect to spend labour reclined in a hospital bed. But studies have shown that actively moving around by walking, changing positions, rolling on a birthing ball or swaying can help ease pain.¹ Being in an upright position can help support the baby’s movement as it moves through the birth canal, while gently rocking your pelvis can ease the discomfort of contractions. These movements can be done almost anywhere and can be used with other complementary therapies. However, movement alone is unlikely to completely relieve you of pain.²

2. Massage

Massage and touch can be calming, can help ease tension and may act as a distraction from labour pain. In a recent study, women who received massage from a physiotherapist during labour reported significantly less pain than those who didn’t, although massage did not change the characteristics of the pain.³

If your partner is likely to be there during childbirth, you can practise being massaged before the birth to discover what feels most comfortable. During some stages of labour, you may find that massage feels good, while at other times it may be distracting or even annoying.

3. Relaxation and breathing

One of the most important parts of your body to relax during labour is your mind. If you’re calm and less anxious, you will be more physically relaxed, which can help reduce the pain. Deep breathing and concentrating inward often come as natural responses for women during contractions. Breathing in through the nose and out through the mouth can help you get into a relaxed state and help you cope better with labour.⁴ You can find out more about this in antenatal classes, which often cover breathing and relaxation techniques. Your midwife will also help you with these techniques during labour.

Medical relief for labour pain

1. Epidural

This is the most common and effective type of pain relief used in labour.⁵ If you choose to have an epidural, an anaesthetist will insert a needle and a tiny tube, called a catheter, in the lower part of your back. An anaesthetic will then be administered via this tube, which usually numbs only the lower section of your body. The aim of an epidural is to make you completely pain free during labour and delivery.

There are a few possible side-effects of epidural anaesthesia to be aware of, including temporary muscle weakness or numbness from the waist down, a lengthened second stage of labour, and tenderness around the injection site. However, epidurals are considered very safe, with serious complications being rare.⁶ An epidural does not increase your chances of needing a caesarean. However, an epidural may increase the chances of forceps being used to help deliver your baby.

2. Opioids

If you’re interested in a form of pain relief that doesn’t cause a total loss of sensation in part of your body or increase your chances of needing assisted delivery, you may want to consider opioids. An opioid, such as morphine, is usually injected into your thigh or buttock – it relieves pain by having an analgesic effect, which means it dulls your feelings of pain but doesn’t have a deep-numbing effect. Opioids normally take about 20 minutes to work after the injection and can last between 2 and 4 hours.

Opioids can sometimes make you feel disorientated or sick, so anti-nausea treatment is often given at the same time. Opioids cross the placenta, which can affect the baby’s breathing, but this can be reversed by another drug should this become a problem.⁷ Morphine can take the edge off your pain, but it won’t take the pain away completely.

3. Nitrous oxide

Nitrous oxide gas, often referred to as ‘laughing gas’, acts quickly and doesn’t affect contractions or stay in the baby or mother’s body. Many women like this option because it’s easy to use and self-controlled – you simply hold the mask and take deep breaths whenever necessary.

On the whole, nitrous oxide is considered a safe pain management option during labour. It won’t remove all the pain but can take the ‘edge’ off it and make it more bearable.

Alternative methods of pain relief

There are various alternative options that may be of interest to you. These include reflexology, hypnosis, massage, aromatherapy, TENS and acupuncture. It’s worth bearing in mind that there is little research proving the effectiveness of some of these treatments, but some women do find them helpful.

Talk through your options with your obstetrician

Childbirth can be an amazing experience, and there are many options for managing the pain associated with it. Although you can’t predict how much pain you will have during labour and delivery, you can prepare yourself for it by discussing the options available to you with your obstetrician beforehand. My patients are welcome to chat to me about this at any of their appointments. To make an appointment, call (03) 9418 8299 or book online.

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